Ronald P D'Agostino DO PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

5101008281 Issued in MI

Legal business name

RONALD P D'AGOSTINO DO PC

Practice address

108 W Eastern Ave
Lanse, MI 49946-1214

Phone

(906) 524-6366

Fax

(906) 524-6014

NPI assigned

Apr 12, 2008

Last updated

Mar 7, 2023By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Ronald P D'Agostino, DO

Title

President/Owner

Phone

(906) 524-7121

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1207958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1548433360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 W EASTERN AVE",
            "city": "LANSE",
            "state": "MI",
            "postal_code": "499461214",
            "telephone_number": "906-524-7121",
            "fax_number": "906-524-6014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 W EASTERN AVE",
            "city": "LANSE",
            "state": "MI",
            "postal_code": "499461214",
            "telephone_number": "906-524-6366",
            "fax_number": "906-524-6014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RONALD P D'AGOSTINO DO PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-12",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "D'AGOSTINO",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "906-524-7121",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101008281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.